Mrs Shanna Wideman, MA, AADC is a
Psychologist - Addiction (substance Use Disorder) based in Martinsburg, West Virginia. Mrs Shanna Wideman is licensed to practice in * (Not Available) (license number ) and her current practice location is
397 Mid Atlantic Pkwy, Suite 3, Martinsburg, West Virginia. She can be reached at her office (for appointments etc.) via phone at
(304) 260-6360.
NPI number for Mrs Shanna Wideman is 1740424506 and her current mailing address is 397 Mid Atlantic Pkwy Ste 3, Martinsburg, West Virginia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1740424506.
Healthcare Provider's Profile
| Full Name | Mrs Shanna Wideman |
|---|
| Gender | Female |
|---|
| Speciality | Psychologist - Addiction (substance Use Disorder) |
|---|
| Location | 397 Mid Atlantic Pkwy, Martinsburg, West Virginia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1740424506
- Provider Enumeration Date: 04/23/2009
- Last Update Date: 10/23/2015
Medical Identifiers
Medical identifiers for Mrs Shanna Wideman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740424506 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103TA0400X | Psychologist - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (* (Not Available)) | Secondary |
| 103TB0200X | Psychologist - Cognitive & Behavioral | (* (Not Available)) | Secondary |
| 103TP0814X | Psychologist - Psychoanalysis | (* (Not Available)) | Secondary |
| 103TR0400X | Psychologist - Rehabilitation | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Shanna Wideman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Shanna Wideman, MA, AADC
397 Mid Atlantic Pkwy Ste 3,
Martinsburg, WV 25404-7468
Ph: (304) 260-6360 | Mrs Shanna Wideman, MA, AADC
397 Mid Atlantic Pkwy, Suite 3,
Martinsburg, WV 25404-7468
Ph: (304) 260-6360 |
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